13-0964 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO �,gl
LA QUINTA, CALIFORNIA 92253 BUILDING 8 SAFETY DEPARTMENT
BUILDING PERMIT
Application Number.
13-000009.64
Property Address:
52795 AVENIDA OBREGON
APN:
773-314-017-4 -000000-
Application description:
PLUMBING
Property Zoning:-
COVE RESIDENTIAL
Application valuation:
3000
Applicant: Architect or Engineer:
Owner:
DAVID MORRIS
52795 AVENIDA OBREGON
LA QUINTA, CA 92253
(760)848-3995
Contractor:
ALMS UNDERGROUND, CONS'
38703 VISTA' DRIVE=
CATHEDRAL. CITY, CA 92;
(76':0) 324'-19.11`
VOICE (760) 777-7012
FAX (760) 7.77-7011
INSPECTIONS (760) 777-7153
Date: 8/01/13
LQPERMIT
Lit. No.: 482180 -
---`------ - - - - - - -z'-'----- -=--'-=--=--------------=---------
h
- LICENSED CONTRACTOR'S DECLARATION
--- --- ------_ --------'=--:--------------
WORKER'S COMPENSATION:DECLARATION
I hereby affirm under penalty of perjury that I am licensed ,under provisions,otChapter 9 (commencing with -
hereby affirm under penalty of perjury.one of3he following•declarations: - -
Section 7600) of.6MO idn 3 of the iness and Prdfessionals Code; and ;ny License is in full force and effect.
'I have and will maintain a nertificate`of consent to self -insure for -workers' compensation, as provided
License•Class . C21 C42 �, ''t 'tens o 482180
_
for,by�Section 3700'of the Labor -Code, for the performance'of the work for.wliich this permit is
issued. F
-by
Date .Z0l 3Co� cto��1/
I�have and willmaintain workers' compensation insurance, as required Section 3700 of the Labor
Code, for the performance of the work for which•this permit'is issued. -My workers' compensation
-WNER-BUILDER DECLARATION
insurance carrier and policy number are:
- I hereby affirm under' penalty of perjury that I m exempt from the Contractor's State License Law for the
Carrier BARRET BUS SRVC Policy Number 2246 '
following reason (Sec. 7031 .5, Business and Professions -Code: Any city or county that requires •a. permit -to
_ I certify that, in the performance of the work for which.this permit'is issued; I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers', compensation laws of California,
permit to file a signed statement that,he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workercompensation provisions Of Section
License Law (Chapter 9 (commencing with Section 7000) of Division of the business and Professions Code) or
3700 of the Lab Code, I shall forthwith c mply 't se provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
�•
any. applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500)-:
(_) 1, as owner of the property, or my employees with wages as their sole;compensation, will do the work, and
fDatel.)N ZO Applicant: . -
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKE COMPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL
-Contractors' State LicenseLaw does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL P IAITIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who doesthewoik himself or herself through his or her own employees, provided that the
DOLLARS 1$100,000): INADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement.issold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
. one year of completion, the -owner -builder will have the burden of proving that he on she did not build or
improve for'the'purpose of sale.).
- APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the'Director of Building and Safety for a permit subject to the
7044,,Business and Professions Code: The Contractors' State License Law does not apply to.an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects.with a contractor(s) licensed -
1. Each person upon whose behalf, this application is made, each person at whose request and.for
pursuant to the Contractors' StateLicense Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, -agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
Date: Owner:
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that th ab ' e information is correct. I agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to buil ing c struction, and hereby aut rize represen i es
'
Lender's Name:
of this•co�ty to enter upon the abovementioned proper r ins ection purpos
/f
Dately�Tx01 S_ignApp�nt or Agent):
Lender's Address:
/
LQPERMIT
Application Number . . . 13-00000964
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee 11.92
Plan Check Fee
.00
Issue Date . . .
Valuation . . .
. 0
Expiration Date 1/28/14
Qty Unit Charge Per
Extension
1.00 . 11.9200 EA PLBG BUILDING
SEWER
11.92
----------------------------------------------------------------------------
S.pecial Notes and Comments
SEWER -ABANDON SEPTIC, SEWER CONNECT.
2010 CALIFORNIA BUILDING CODES.
_ -------------------- -------------------- ---------
Other Fees . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
PERMIT
ISSUANCE M/P/E
90.57
Fee summary Charged Paid
Credited
Due
Permit Fee Total 11.92
.00 .00
11.92
Plan Check Total .00
.00 .00
.00
Other Fee Total 91.57
.00 .00
91.57
Grand Total. .103.49
.00 .00
103.49
LQPERMIT
Bin #
City of L.a Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: S� 7 l v e 0 6 rzJo tx '
Owner's Name: dtv i d Marr ' s
A. P. Number:
Address: '-�7 9 S' O
Legal Description:
Contractor:
/s �n ro nco a1
City, ST, Zip: L '
telephone; hone•
Address: ?8 703 (Z i S+a Z�r
Project Description: 5z w¢.r c o-„ v% e c`t o r
City, ST, Zip: end ro_� Ccs . 97-2-3V
Telephone:
Tele P 3 2 y J �I
rilif •i:ii:i'�ii'
State Lic. # 41 a.Z / 2-0
City Lic. #: 7E
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: h ne:
P
4i1 ::i�:.:i�ii{iY.{i1+:;:j:::} f �vr•>ii::±::?iin
:.:;.;;>;;:::::;:;::.;;;;
0
C nstruction Type:' Occupancy:
P P Y:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 3 DO -0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
AQ, COACHELLA VALLEY WATER DISTRICT
.t P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 7/26/2013
SUBJECT: SCC ONLY- 52795 AVENIDA OBREGON, LA QUINTA, LID 685162
Morris Project:
52795 Avenida Obregon Project Date:
A Amount Due:
LA QUINTA, CA 92253 GEO:
Planner:
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
13-4736
7/26/2013
$4,851.00
06-06-12-2
CAROLPFANNKUCHE
1.00 SCC -COLLECTION 1 $2,415.001 $2,415.00
1.00 SCC -TREATMENT 1 $2,436.001 $2,436.00
$4,851.00
pr D
JUL 2 6 2013
COACHELLA VALLEY
. WATER DISTRICT
703Y 7o> ►a q
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m o m o o m m- m■ o
°U72347'CASHIER'S CHECK
7234701129
Office AU # 1210(8)
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Operator LO.: u238462 cu002914
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Jul .2Q; 2013
0
TO THE ORDER OF ***COACHELLA VALLEY :WATER -DISTRICT***
�
PAY
L'J
* thousand.relght hundred fifty one dollars and no cents
$4,851.00.
.*Four
'.
VOID IF OVER US $ 4,851.00
"WELLS FARGo BANK 'N A.7k34'''
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LA UINiA,'.CA 92253.
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fOR1NOUIRIES CALL (480) 394-3122m
CONTROLLER„
II'723470LL29,18 1:1210002481:486L SL147S11'